RESUMEN
Intestinal malrotation is caused by a developmental anomaly of the embryonic intestine. Most cases develop in neonates, and development in adulthood is rare and difficult to diagnose before surgery. Pancreaticoduodenectomy was performed for cancer of the ampulla of Vater accompanied by incomplete fixation in a 63-year-old male patient. A branch of the superior mesenteric artery was present on the resection line and was deemed likely to cause circulatory disorder in the small intestine, and the duodenum and jejunum were covered with a membranous structure making dissection, anatomical identification, and jejunectomy difficult. Herein, we report the case with a review of the literature.
Asunto(s)
Adenocarcinoma/patología , Ampolla Hepatopancreática/patología , Neoplasias del Conducto Colédoco/patología , Duodeno/anomalías , Vólvulo Intestinal/congénito , Yeyuno/anomalías , Arteria Mesentérica Superior/anomalías , Adenocarcinoma/diagnóstico por imagen , Adenocarcinoma/cirugía , Ampolla Hepatopancreática/diagnóstico por imagen , Ampolla Hepatopancreática/cirugía , Neoplasias del Conducto Colédoco/diagnóstico por imagen , Neoplasias del Conducto Colédoco/cirugía , Anomalías del Sistema Digestivo/diagnóstico por imagen , Anomalías del Sistema Digestivo/cirugía , Disección , Duodeno/diagnóstico por imagen , Duodeno/cirugía , Humanos , Vólvulo Intestinal/diagnóstico por imagen , Vólvulo Intestinal/cirugía , Yeyuno/diagnóstico por imagen , Yeyuno/cirugía , Masculino , Arteria Mesentérica Superior/diagnóstico por imagen , Arteria Mesentérica Superior/cirugía , Persona de Mediana Edad , Estadificación de Neoplasias , Pancreaticoduodenectomía , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
60-year-old woman was referred to us for epigastralagia under the diagnosis of chronic cholecystitis. Cholecystectomy was performed, and gallbladder carcinoma was pinpointed by postoperative pathological diagnosis. Because liver invasion should have been detected by pathological diagnosis, we conducted liver S4a+S5 resection, extrahepatic bile duct resection and D2 lymphadenectomy. The pathological diagnosis was advanced gallbladder carcinoma with liver metastasis. We treated a patient with curative operation and hepatic arterial infusion adjuvant chemotherapy by low-dose FP therapy for advanced gallbladder carcinoma, and she is doing well now without disease recurrence eight years after surgery.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Neoplasias de la Vesícula Biliar/tratamiento farmacológico , Neoplasias de la Vesícula Biliar/cirugía , Femenino , Neoplasias de la Vesícula Biliar/patología , Arteria Hepática , Humanos , Infusiones Intraarteriales , Neoplasias Hepáticas/tratamiento farmacológico , Neoplasias Hepáticas/secundario , Neoplasias Hepáticas/cirugía , Factores de TiempoRESUMEN
We schemed intraperitoneal gemcitabine (ipGEM) for reduction of peritoneal dissemination to three patients with unresectable and one patient with recurrent pancreatic cancer, followed by intraperitoneal catheter and subcutaneous port placement. Two locally advanced cases were performed for intra-operative radiotherapy, and one of 2 locally advanced cases was performed for gastrojejunostomy. And another locally advanced case had ileostomy. The recurrent case was resected for metastatic tumor of abdominal wall. In one of locally advanced cases, we couldn't perform ipGEM for progression of disease. In two remaining locally advanced cases, we could keep on doing ipGEM, and the patients did not experience with abdominal discomfort or hematological toxicity.
Asunto(s)
Desoxicitidina/análogos & derivados , Neoplasias Pancreáticas/tratamiento farmacológico , Neoplasias Peritoneales/tratamiento farmacológico , Anciano , Desoxicitidina/administración & dosificación , Desoxicitidina/uso terapéutico , Humanos , Infusiones Parenterales , Masculino , Persona de Mediana Edad , Neoplasias Pancreáticas/patología , Neoplasias Pancreáticas/cirugía , Neoplasias Peritoneales/secundario , Proyectos Piloto , GemcitabinaRESUMEN
BACKGROUND: Prognosis of pancreas cancer is extremely poor. For unresectable pancreas cancer, there has not been an effective method of treating. In our institution, the mean survival time was 13 . 6 months for a chemoradiotherapy case that used gemcitabine (GEM), but was 7.3 months for a non-treatment case in locally advanced and metastatic pancreas cancer. This time, we experienced a good case for unresectable pancreas cancer treated with chemoradiotherapy using GEM/S-1 that clearly exhibited a decrease in tumor size by tumor marker.